Efficacy of the Hacor Score in Predicting Non-Invasive Ventilation Failure in Acute Exacerbation of Copd

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major global health burden, with acute exacerbations frequently necessitating non-invasive ventilation (NIV). Early prediction of NIV failure can improve outcomes by guiding timely intubation. The HACOR score—comprising heart rate, acidosis, consciousness, oxygenation, and respiratory rate—has shown promise in predicting NIV failure. Objective:To evaluate the predictive accuracy of the HACOR score in COPD patients with acute respiratory failure receiving NIV.Methods:This cross-sectional study included 100 COPD patients initiated on NIV at MIMS Mandya,Karnataka. HACOR scores were calculated two hours after NIV initiation. Patients were monitored for NIV outcomes, and statistical analysis was performed using ROC curves. Results: NIV failure occurred in 31% of patients. AHACOR score ≥5 was significantly associated with failure (sensitivity 83.9%, specificity 76.8%, AUC = 0.80). Early intubation based on HACOR reduced mortality compared to delayed intubation. Conclusion: The HACOR score is an effective bedside tool for early prediction of NIVfailure in COPD.